Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies

Introduction: Studies have shown a shift in the prevalence from Gram-positive to Gram-negative bacteraemia in patients with haematological malignancies who develop febrile neutropenia. There are also reports on the spread of drug resistant bacteria among these patients. Information about locally pr...

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Main Authors: Prathyusha Kokkayil, Reshu Agarwal, Sarita Mohapatra, Sameer Bakshi, Bimal Das, Seema Sood, Benu Dhawan, Arti Kapil
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/9725
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author Prathyusha Kokkayil
Reshu Agarwal
Sarita Mohapatra
Sameer Bakshi
Bimal Das
Seema Sood
Benu Dhawan
Arti Kapil
author_facet Prathyusha Kokkayil
Reshu Agarwal
Sarita Mohapatra
Sameer Bakshi
Bimal Das
Seema Sood
Benu Dhawan
Arti Kapil
author_sort Prathyusha Kokkayil
collection DOAJ
description Introduction: Studies have shown a shift in the prevalence from Gram-positive to Gram-negative bacteraemia in patients with haematological malignancies who develop febrile neutropenia. There are also reports on the spread of drug resistant bacteria among these patients. Information about locally prevalent bacteria and their resistance is important to guide empirical therapy. The aim of this study was to characterise the bacterial spectrum and antibiotic resistance pattern of bacteraemia in neutropenic patients with haematological malignancies Methodology: In this retrospective study, patients admitted to Haematology and Oncology units over a period of 6 months with laboratory-confirmed positive blood cultures were enrolled. Information regarding demographic profile, clinical features, and microbiological profile were recorded. Standard procedures were applied to identify the isolates and their resistance patterns. The data collected was analysed statistically. Results:56 isolates from 53 patients were isolated of which majority were gram negative bacilli (GNB; n = 52 or 93%). Klebsiella pneumoniae (43%, n = 24) was the most frequently isolated bacteria followed by Enterobacter sp (20%, n = 11) and Escherichia coli (12%, n = 7). All isolates were susceptible to colistin. Susceptibility to cefaperazone-sulbactam, piperacillin-tazobactam and carbapenems were 32%, 28.6% and 26.8% respectively. The outcome was fatal for 25 patients. Conclusions: The study documented an alarming rise in the prevalence of GNB and their resistance. Though the results of the study may represent only the tip of the iceberg, the results demonstrate the need for treatment options for drug resistant isolates and for surveillance cultures.
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spelling doaj-art-88eecf059c1b4706809323c859c7b2152025-08-20T02:27:11ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-06-01120610.3855/jidc.9725Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignanciesPrathyusha Kokkayil0Reshu Agarwal1Sarita Mohapatra2Sameer Bakshi3Bimal Das4Seema Sood5Benu Dhawan6Arti Kapil7Government Medical College, Palakkad, Kerala, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, IndiaAll India Institute of Medical Sciences, New Delhi, India Introduction: Studies have shown a shift in the prevalence from Gram-positive to Gram-negative bacteraemia in patients with haematological malignancies who develop febrile neutropenia. There are also reports on the spread of drug resistant bacteria among these patients. Information about locally prevalent bacteria and their resistance is important to guide empirical therapy. The aim of this study was to characterise the bacterial spectrum and antibiotic resistance pattern of bacteraemia in neutropenic patients with haematological malignancies Methodology: In this retrospective study, patients admitted to Haematology and Oncology units over a period of 6 months with laboratory-confirmed positive blood cultures were enrolled. Information regarding demographic profile, clinical features, and microbiological profile were recorded. Standard procedures were applied to identify the isolates and their resistance patterns. The data collected was analysed statistically. Results:56 isolates from 53 patients were isolated of which majority were gram negative bacilli (GNB; n = 52 or 93%). Klebsiella pneumoniae (43%, n = 24) was the most frequently isolated bacteria followed by Enterobacter sp (20%, n = 11) and Escherichia coli (12%, n = 7). All isolates were susceptible to colistin. Susceptibility to cefaperazone-sulbactam, piperacillin-tazobactam and carbapenems were 32%, 28.6% and 26.8% respectively. The outcome was fatal for 25 patients. Conclusions: The study documented an alarming rise in the prevalence of GNB and their resistance. Though the results of the study may represent only the tip of the iceberg, the results demonstrate the need for treatment options for drug resistant isolates and for surveillance cultures. https://jidc.org/index.php/journal/article/view/9725bloodstream infectionKlebsiella pneumoniaeantibiotic resistancefebrile neutropeniahaematological malignancy
spellingShingle Prathyusha Kokkayil
Reshu Agarwal
Sarita Mohapatra
Sameer Bakshi
Bimal Das
Seema Sood
Benu Dhawan
Arti Kapil
Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
Journal of Infection in Developing Countries
bloodstream infection
Klebsiella pneumoniae
antibiotic resistance
febrile neutropenia
haematological malignancy
title Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
title_full Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
title_fullStr Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
title_full_unstemmed Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
title_short Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
title_sort bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies
topic bloodstream infection
Klebsiella pneumoniae
antibiotic resistance
febrile neutropenia
haematological malignancy
url https://jidc.org/index.php/journal/article/view/9725
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